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Dr. C.
Dr. C., Board Certified
Category: OB GYN
Satisfied Customers: 2537
Experience:  30 years of experience and an award-winning educator.
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I have been taking ovulation induction drugs cycles now and

Customer Question

I have been taking ovulation induction drugs for 5 cycles now and am not sure whether it is worth continuing as I seem to be getting highly mixed results. I have tried:
- Clomiphene 5 mg - oestradiol day12 = 1600, didn't scan for follicles, no progesterone at day 21. Took Provera, got a period.
- Clomiphene 2.5 mg - oestradiol day 12 = 1200, didn't scan for follicles, no progesterone at day 21. Took Provera, no period.
- Letrozole 2.5 mg - oestradiol day 12 134; oestradiol day 16 122, scan day 16 no dominant follicle (a few follicles around 10mm) and endometrial thickness 6mm. No period. Took provera. No period.
- Letrozole 5 mg - oestradiol day 10 =212, oestradiol day 17 = 157; scan day 17 showed one dominant follicle 24x22mm but endometrium only 5mm; used Ovidrel day 17; progesterone test day 25 = 19. Got period day 30.
Had a break from taking drugs for a month then tried:
- Letrozole 7.5 mg - oestradiol day 12 = 1040; scan day 12 showed one dominant follicle 30mm so used Ovidrel, got period on day 25.
- Letrozole 7.5 mg - oestradiol day 12 = <44!
I have no idea what is happening. Is it worth continuing with Letrozole or trying Clomiphene again with scans this time? I'm so confused and my gynocologist isn't getting back to me so I think she may not know what to do either. What would you recommend?
Submitted: 9 months ago.
Category: OB GYN
Expert:  Dr Ted Manos replied 9 months ago.

Hello, I'm Dr Manos MD, board certified obgyn. I'm retired from active practice for over a year but I'm consulted off and on because of my reputation in obstetrics and infertility. I've read your information and I don't understand the clomiphene dosing. For many decades, Clomid 50 mgs day 5-9 of the cycle was the standard and the results were quite good. I always followed the follicle or two and when it looked ripe I had the patient have intercourse. I followed a few cycles and would increase the Clomid to either 50mgs for day 4-11 or 75 mgs day 4-9. We didn't have lotrozole and I imagine it might have been a little better in taking it once and it blocked estrogen to boost FSH and LH production. Either way scanning is very important to see which way to go. With Clomid and I imagine lotrozole the direct effect on the endometrium was a concern but the least of the concerns. Good follicle, good endometrium. I would inquire about the dose of Clomid and why so low a dose for starters